雌激素对纵隔子宫电切术后宫腔纤维化的影响

Effect of estrogen on uterine fibrosis following transcervical resection of septum

摘要:

目的 探讨雌激素对纵隔子宫电切术后宫腔纤维化的影响。方法 选取2016 年1 月—2017 年6 月 重庆市妇幼保健院收治的110 例经宫腔镜检查证实后行纵隔子宫电切术的纵隔子宫患者（包括完全纵隔子宫 和不完全纵隔子宫），分为实验组58 例（雌激素治疗：补佳乐2 mg/ 次，2 次/d，共21 d ；最后10 d 加用地屈孕 酮10 mg/ 次，2 次/d）和对照组52 例（不使用雌激素治疗）。治疗1 个月后再次行宫腔镜检查，评估宫腔情况， 记录宫腔粘连发生情况；同时取子宫内膜组织。通过免疫组织化学染色检测转化生长因子-β（TGF-β）及 结缔组织生长因子（CTGF）蛋白表达的差异，进一步通过RT-PCR 检测TGF-β 及CTGF mRNA 的表达。 结果 对照组和实验组纵隔子宫电切术术后粘连发生率分别为1.9% 和5.1%，差异无统计学意义（P >0.05）。两 组子宫内膜组织中TGF-β 及CTGF 表达比较，差异无统计学意义（P >0.05）。结论 雌激素不能改变纵隔子 宫电切术后宫腔纤维化进程，可能是因为雌激素不能改变纤维化因子TGF-β 及CTGF 的表达所致。

Abstract:

Objective To probe the effection of estrogen on uterine fibrosis following transcervical resection of septum (TCRS). Methods Totally 110 patients who underwent hysteroscopic septum resection in our hospital from January 2016 to May 2017 were allocated into two groups. In experimental group (58 patients), women received postoperative estrogen therapy, No medication was received in control group (52 patients). Further hysteroscopy was performed to assess the uterine cavity in one month later of the initial surgery. Endometrium was collected to detect the expressions of TGF-β and CTGF through immunohistochemistry and PCR. Results The postoperative adhesion rates between the two groups at one month were 1.9% (control group) and 5.1% (experimental group), respectively (P > 0.05). The expression levels of TGF-β and CTGF through immunohistochemistry and PCR in endometrium were no significant difference between the two groups (P > 0.05). Conclusions Estrogen cannot change the process of uterine fibrosis following TCRS, which is related to that estrogen cannot change the expressions of TGF-β and CTGF.